Output 1.3 Public Health Services
Public Health Services provides high quality health and community services to the ACT and surrounding region. The key strategic priorities for Public Health Services include monitoring the health of the ACT population, promoting health, preventing disease, improving health equity, protecting the health of the public, and supporting workforce excellence (Population Health Division).
Public health services in the ACT are largely provided through the Population Health Division. The Population Health Division is headed by the Chief Health Officer who is appointed under the Public Health Act 1997 and reports to the Director-General of ACT Health. The Chief Health Officer is also required to report biennially on the health of the ACT population on specific health-related topics, which is done through the Chief Health Officer’s Report.
The Population Health Division has primary responsibility for the management of population health issues within ACT Health. The Division undertakes the core functions of prevention, assessment, policy development and assurance, and contributes to local and national policy, program delivery and protocols on population health issues. As of 1 July 2012, the Population Health Division has implemented a new structure:
- The Health Improvement Branch is responsible for improving the health and wellbeing of the ACT population through promoting healthy behaviours and lifestyles—and providing ongoing monitoring and evaluation of health programs and policy. The Branch includes the ACT Cancer Registry, ACT Cervical Cytology Screening Program and the ACT Health Promotion Grants Program.
- The Health Protection Service manages risks and implements strategies for the prevention of, and timely response to, public health incidents. This is achieved through a range of regulatory and policy activities relating to areas such as food safety, communicable disease control, environmental health, emergency management, pharmaceutical products, tobacco control, and analytical services.
- The Office of the Chief Health Officer (OCHO) is responsible for providing public health advice—both internally and externally to the division—as well as high-level project and policy work on behalf of the CHO. Key policy priority areas for the OCHO include gene technology; climate change; the Whole-of-Government Healthy Weight Initiative; and the Whole of Government Initiative on Injury Prevention.
- The Population Health Division fulfilled its statutory and national reporting requirements for 2012‑13. These included the collection of data for, and maintenance of, the ACT Cancer Registry and Maternal and Perinatal Data Collection. The Population Health Division fulfilled national reporting requirements on public health expenditure, cancer incidence and mortality, and maternal and perinatal statistics for the ACT.
- On 24 August 2012, the Minister for Health, Katy Gallagher, tabled the 2012 Chief Health Officer’s Report. The report is a legislated requirement under the Public Health Act and profiles the health of the ACT population, including mortality, morbidity, health-service use and social factors influencing health.
- The Population Health Division has a Survey Program that supports the monitoring of population health trends across the Australian Capital Territory. Survey results are published in a number of reports and health series publications which are utilised to inform health policy and program development. The Survey Program includes:
- – the ACT General Health Survey, a telephone computer-assisted technology household survey which collects information across a range of factors influencing health status in the ACT.
- – the ACT Secondary School Alcohol and Drug Survey, a classroom-based questionnaire conducted every three years, collecting information on risk behaviours of ACT secondary school students including alcohol, tobacco and illicit drug use
- – the ACT Year 6 Physical Activity and Nutrition Survey, a classroom-based questionnaire conducted every three years on children’s weight status, physical activity and nutrition
- The report, The Health of Aboriginal and Torres Strait Islander People in the ACT 2006–2011 was published in January 2013. This report provides a demographic overview of Aboriginal and Torres Strait Islander people living in the ACT and examines factors influencing their health profile.
- In 2012‑13, the Population Health Division continued to strengthen its quality systems in population health data collection and reporting. This included working toward the development of systems for the electronic transmission of maternal and perinatal data in the ACT, with one notifier developing the capacity to transmit data electronically during this reporting period. The Population Health Division has also continued to build local capacity in data linkage between key population health data collections.
- In late June 2013, a new notifiable diseases database was implemented after a lengthy development period. The new system will enable more efficient recording and management of notifiable diseases, and will provide accurate, consistent information that complies with national reporting requirements. The database was one of the last remaining recommendations to be finalised from the evaluation of the response to the H1N1 Influenza 2009 pandemic.
- A food safety guide for businesses was finalised and translated into 11 languages to ensure food safety information was available to non-English speakers. The food safety guide provides comprehensive information about the most common food safety requirements.
- A food stall guideline for temporary food stalls was developed and translated into 12 languages. The food stall guideline is designed to assist organisers of food stalls at outdoor events in the ACT to meet all necessary food safety requirements.
- The Food (Nutritional Information) Amendment Act 2011 commenced operation on 1 January 2013, requiring certain food businesses to display the kilojoule (kJ) content of their standard items on menus and price tags. The businesses will also need to display the statement ‘The average adult daily energy intake is 8,700kJ’ in one location on each menu board and food display stand. Kilojoule displays may encourage consumers to make healthier food choices and promote dietary awareness. They may also encourage food businesses to reformulate foods into healthier options.
- The Food Amendment Bill 2012 introduced a new requirement for food safety supervisors. From 1 September 2013, all registered food businesses are required to appoint a food safety supervisor responsible for ensuring that hygiene and food safety standards are achieved and maintained in food businesses. The food safety supervisor must complete prescribed training, which will remain current for five years. The ACT Health website provides full information about food safety supervisors, including training requirements.
- In February 2013, a team of 12 public health officers conducted food inspections during the three-day National Multicultural Festival as a strategy to minimise public health risks from serious breaches of the Food Act 2001. In total, approximately 300 inspections were conducted over the duration of the event. During inspections of food stalls, Public Health Officers routinely look for issues (breaches) that would give rise to unacceptable food safety risks including temperature control, poor hand-washing facilities and insufficient food storage. A number of food safety breaches were identified, including one food seizure and 12 voluntary disposals of deteriorated food items.
- – Prior to the event, the Environmental Health (EH) team undertook four community consultation forums. Two were attended by prospective stallholders and one was for a community organisation which requested an additional food safety talk. The final forum was aimed at festival volunteers.
- – The Pharmaceutical Service Section (PSS) attended a number of community consultation forums while establishing the kava exemption for the festival. Once the kava exemption was in place, a specific forum was held with the communities directly involved with the cultural use of kava, at which the exemption was clearly articulated and explained to stakeholders.
- The Health Protection Service responded to two major outbreaks of gastrointestinal illness among diners who reported eating at two restaurants in the ACT over the weekend of 11 and 12 May 2013. The first outbreak had 162 cases of gastrointestinal illness, with 78 of these confirmed as Salmonella infections. Of those that have been tested, Salmonella typhimurium 170 has been identified as the causative serotype. More than 90 cases of illness were reported in the second outbreak. During the investigation, Health Protection Service staff interviewed more than 400 people (both well and unwell) from both outbreaks, conducted multiple inspections of the implicated restaurants, and sampled and tested 109 food items from one restaurant. Interviews, inspections and testing of food supported the clinical and epidemiological findings. The response involved significant collaboration between Health Protection Service, the Canberra and Calvary hospitals, and local and interstate laboratories, and included the utilisation of the Health Emergency Coordination Centre. This collaboration and hard work by all, both in the outbreak investigation and in maintaining routine business operations, contributed to the successful investigation and resolution of the outbreak.
- The Health Protection Service conducted a Legionella Cooling Towers survey, Oriental Grocers food survey, Fresh Squeezed Juice survey and Ready to Eat food survey to determine the bacteriological status and compliance with the relevant legislation and codes of practice.
- The Chief Health Officer worked closely with the ACT Medicare Local, and both Canberra and Calvary Hospitals to coordinate and document 2013 winter preparedness activities. The subsequent 2013 ACT Health Sector Winter Plan was launched at a media release on 16 April 2013. The 2013 ACT Health Sector Winter Plan documents preparedness activities by agency including stockpiling of essential medicines and equipment, streamlining infectious disease testing, improving surveillance arrangements and developing health facility escalation plans.
- A review and major revision of the Public Health Emergency Response Plan 2007 was undertaken. The revised Plan was endorsed in early 2013.
- In 2011, the Health Emergency Management Sub Committee agreed to develop four appendices to the Health Emergency Plan. The Health Emergency Plan Appendix I: ACTBurnPlan and Appendix II: HealthEvacPlan were endorsed by the Health Emergency Management Sub Committee out of session on 30 July 2012. The draft Health Emergency Plan Appendix III: HealthCBRNPlan was endorsed without change at the Health Emergency Management Sub Committee meeting of 18 June 2012. The draft Health Emergency Plan Appendix IV: Part A—Summer Plan, was also endorsed at the same meeting with minor amendment. The final draft appendix, Appendix IV: Part B—Winter Plan, remains a work in progress. The expected completion date is February 2014, following a trial over the 2013 winter. Once completed, all of the Health Emergency Plan appendices will be provided to the Security and Emergency Management Senior Officials Group, through the ACT Health Executive Council for information.
- The Population Health Division led a consultation process with the ACT Pacific Island community in 2012 regarding an ACT exemption for cultural kava use. Recommendations were subsequently provided to the Minister for Health. An amendment to the Medicines, Poisons and Therapeutic Goods Regulation 2008 was made on 25 January 2013 to enable use of kava for cultural purposes at declared public events. On 29 January 2013, the Minister for Health declared the National Multicultural Festival held in Canberra each year to be an exempt public event. These changes followed detailed consultation with the ACT Pacific Island community. Overall the serving of kava at the 2013 National Multicultural Festival was regarded to be a success. Officers of the Health Protection Service attended the event to observe stallholder compliance with the exemption.
- The 2011‑12 ACT Health Annual Report noted that the Minister had agreed to introduce a new licensing scheme for community pharmacies under the Public Health Act 1997. This was successfully implemented by the Health Protection Service over 2012‑13. The new licensing scheme came into effect on 1 March 2013 with all existing ACT pharmacies licensed by the required date.
Issues and challenges
- The Population Health Division implemented a new testing method for recreational waters. Since the introduction of the Microbiological Guidelines for the ACT Recreational Waters in 2010, the Health Protection Service has been striving to improve sample turnaround times and the responsiveness of the service on the Public Health status of the local lakes and rivers. This has reduced testing turnaround times from 48 hours to 24 hours and provided the capability to resample sites promptly and provide the community surety regarding the status of our local lakes.
- The Health Improvement Branch is developing a new web platform for reporting on national and local indicators, as well as other population health priorities.
- The Population Health Division undertook an internal review of options to change the requirements for prescribing controlled medicines under the Medicines, Poisons and Therapeutic Goods Act 2008. The review followed a number of complaints from the medical and pharmacist communities that the current system imposes excessive regulatory burden and is not achieving its public health objectives. The Health Protection Service (HPS) will be implementing a new real-time monitoring system for controlled medicines in 2013‑14. This will involve transmission of data from ACT pharmacies electronically in real time for every controlled medicine that is dispensed. The new system will provide the HPS with a vastly improved tool for monitoring the supply of controlled medicines in the ACT. This is with the view to minimise the risk of harms associated with their misuse, abuse and diversion.
- The ACT Government announced on 13 June 2013 that commercial solariums will be banned in the ACT from 31 December 2014. The ban is expected to help lower the incidence of skin cancers in the ACT, and is in line with similar bans in other jurisdictions commencing on the same date.
- ACT Health collaborated with the University of Canberra on the establishment of an accredited Environmental Health course in the ACT. The need for this collaboration was outlined in the 2011 Auditor-General’s Report, which identified a necessity for ACT Health to promote the development of an accredited Environmental Health course at a local University to address the shortage of skilled Environmental Health Officers. The collaboration with the University of Canberra seeks to promote environmental health careers and help to address the Environmental Health Officer workforce shortage. The collaboration also hopes to facilitate communication between NSW regional local government, other enforcement agencies, tertiary institutions and ACT Health. It will also ensure the provision of appropriate undergraduate training and network opportunities for students embarking on a career in environmental health. The Environmental Health course is understood to commence in 2014.
- The Population Health Division is expanding the ambient air monitoring network by establishing an Ambient Air Quality National Environment Protection Measure Performance Monitoring Station in the Belconnen region. This station will assist with assessing and developing policies around ambient air quality. It is expected the establishment of the station at Florey will be completed by December 2013.
- Scoping and development work for a website featuring air quality data has been undertaken by the Population Health Division. The aim is to allow the public access to ambient air quality data in the Canberra region, with the view to having an Air Quality Index to provide an overall rating of the ambient air quality.
- The HPS continues work on developing further enforcement strategies regarding food regulation. This includes scoping work on a food hygiene grading scheme for food businesses, often called ‘Scores on Doors’, pending agreement from the ACT Government. This work will involve consultation with relevant stakeholders, including representatives from food industry, community and public health groups. The HPS will continue to consult with stakeholders concerning food regulation matters.
- The HPS is implementing the food safety supervisor training requirement, which will become mandatory on
1 September 2013. The HPS also continues to strengthen food safety information base for food businesses and the general public by reviewing current and developing new information.